Table 1.

Summary of National Comprehensive Cancer Network1 and European LeukemiaNet Guidelines for post‐remission therapy in patients with AML5

National Comprehensive Cancer Network
Patients aged <60 y with favorable risk	• HiDAC 3 g/m2 over 3 h every 12 h on days 1, 3, 5 or 1, 2, 3 × 3‐4 cycles, or • Cytarabine 1000 mg/m2 every 12 h on days 1‐4 + daunorubicin 60 mg/m2 on day 1 (first cycle) or days 1‐2 (second cycle) + gemtuzumab ozogamicin 3 mg/m2 on day 1 × 2 cycles (CD33‐positive)
Patients aged <60 y with intermediate risk	Matched sibling or alternative donor HCT, or HiDAC 1.5‐3 g/m2 over 3 h every 12 h on days 1, 3, 5 or 1, 2, 3 × 3‐4 cycles, or HiDAC 1.5‐3 g/m2 over 3 h every 12 h on days 1, 3, 5 or 1, 2, 3 with oral midostaurin 50 mg every 12 h on days 8‐21 (FLT3‐mutated AML), or Cytarabine 1000 mg/m2 every 12 h on days 1‐4 + daunorubicin 60 mg/m2 on day 1 (first cycle) or days 1‐2 (second cycle) + gemtuzumab ozogamicin 3 mg/m2 on day 1 × 2 cycles (CD33‐positive)
Patients aged <60 y with treatment‐related disease other than CBF and/or with poor risk	Matched sibling or alternative donor HCT, or HiDAC 1.5‐3 g/m2 every 12 h on days 1, 3, 5 or 1, 2, 3 × 3‐4 cycles, or HiDAC 1.5‐3 g/m2 every 12 h on days 1, 3, 5 or 1, 2, 3 with oral midostaurin 50 mg every 12 h on days 8‐21 (FLT3‐mutated AML), or Dual‐drug liposomal encapsulation cytarabine 65 mg/m2 and daunorubicin 29 mg/m2 on days 1 and 3 (cytotoxic therapy‐related AML or patients with antecedent MDS/CMML or cytogenetic changes consistent with MDS)
Patients aged ≥60 y with CR after intensive induction therapy	Reduced‐intensity HCT, or Standard‐dose cytarabine with or without an anthracycline (idarubicin or daunorubicin) or intermediate‐dose cytarabine for 4‐6 doses for 1 or 2 cycles (if good performance status, normal renal function, better‐risk or normal karyotype and favorable molecular markers), or Dual‐drug liposomal encapsulation cytarabine 65 mg/m2 and daunorubicin 29 mg/m2 on days 1 and 3 (cytotoxic therapy‐related AML or patients with antecedent MDS/CMML or cytogenetic changes consistent with MDS), or Cytarabine 1000 mg/m2 every 12 h on days 1‐4 + daunorubicin 60 mg/m2 on day 1 (first cycle) or days 1‐2 (second cycle) + gemtuzumab ozogamicin 3 mg/m2 on day 1 × 2 cycles (CD33‐positive), or Maintenance therapy with hypomethylating agents (5‐azacitidine, decitabine) every 4‐6 weeks until progression (if patient received hypomethylating agents during induction)
Patients aged ≥60 y with CR after lower intensity therapy	Reduced‐intensity HCT Hypomethylating agents (5‐azacitidine or decitabine) every 4‐6 weeks until progression Gemtuzumab ozogamicin 2 mg/m2 on day 1 every 4 weeks up to 8 continuation courses (CD33‐positive) Continue enasidenib (IDH2‐mutated AML) or ivosidenib (IDH1‐mutated AML) until progression

European LeukemiaNet
Younger patients (18–60/65 y)
Favorable risk genetics	2 to 4 cycles of IDAC (1000‐1500 mg/m2 every 12 h, days 1‐3 or days 1‐5 or 6) additional therapy Midostaurin for patients with FLT3 mutations (administered after the chemotherapy)
Intermediate risk genetics	Allogeneic HCT from matched‐related or unrelated donor, or 2 to 4 cycles of IDAC, or High‐dose therapy and autologous HCT Midostaurin for patients with FLT3 mutations (administered after the chemotherapy)
Adverse risk genetics	Allogeneic HCT from matched‐related or unrelated donor Midostaurin for patients with FLT3 mutations (administered after the chemotherapy)
Older patients (>60/65 y)
Favorable risk genetics	2 to 3 cycles of IDAC (500‐1000 mg/m2 every 12 h, days 1‐3 or days 1‐5 or 6)
Intermediate/adverse risk genetics	No established value; consider allogeneic HCT with a low HCT‐Comorbidity Index, or investigational therapy

Abbreviations: AML, acute myeloid leukemia; CBF, core‐binding factor; CMML, chronic myelomonocytic leukemia; CR, complete remission; HiDAC, high‐dose cytarabine; HCT, hematopoietic cell transplant; IDAC, intermediate dose cytarabine; MDS, myelodysplastic syndrome.